Efficacy of Chinese Herbal Medicine for Diarrhea-Predominant Irritable Bowel Syndrome: A Meta-Analysis of Randomized, Double-Blind, Placebo-Controlled Trials.
“This meta-analysis shows that Chinese herbal medicine is an effective and safe treatment for Diarrhea-predominant-IBS.”
Evid Based Complement Alternat Med. 2016;2016:4071260. doi: 10.1155/2016/4071260. Epub 2016 Jul 31.
Zhu JJ1, Liu S2, Su XL3, Wang ZS2, Guo Y4, Li YJ4, Yang Y3, Hou LW3, Wang QG2, Wei RH5, Yang JQ3, Wei W3.
To explore the efficacy of Chinese herbal medicine in treating diarrhea-predominant irritable bowel syndrome (D-IBS).
Four English and four Chinese databases were searched through November, 2015. Randomized, double-blind and placebo-controlled trials were selected. Data extraction and quality evaluation were performed by two authors independently. RevMan 5.2.0 software was applied to analyze the data of included trials.
A total of 14 trials involving 1551 patients were included. Meta-analysis demonstrated superior global symptom improvement (RR = 1.62; 95% CI 1.31, 2.00; P < 0.00001; number needed to treat = 3.6), abdominal pain improvement (RR = 1.95; 95% CI 1.61, 2.35; P < 0.00001), diarrhea improvement (RR = 1.87; 95% CI 1.60, 2.20; P < 0.00001), pain threshold assessment (MD = 54.53; 95% CI 38.76, 70.30; P < 0.00001), and lower IBS Symptom Severity Score (SMD = -1.01; 95% CI -1.72, -0.30; P = 0.005), when compared with placebo, while for defecation threshold assessment, quality of life, and adverse events, no differences were found between treatment groups and controlled groups.
This meta-analysis shows that Chinese herbal medicine is an effective and safe treatment for D-IBS. However, due to the small sample size and high heterogeneity, further studies are required.
Efficacy of a Chinese Herbal Medicine in Providing Adequate Relief of Constipation-predominant Irritable Bowel Syndrome: A Randomized Controlled Trial.
“In a prospective, controlled study, Chinese herbal medicine reduced symptoms of Constipation-predominant-IBS, increased bowel satisfaction and stool consistency, and reduced straining and hard lumpy stools, compared with placebo.”
Clin Gastroenterol Hepatol. 2015 Nov;13(11):1946-54.e1. doi: 10.1016/j.cgh.2015.06.022. Epub 2015 Jun 29.
Bensoussan A1, Kellow JE2, Bourchier SJ3, Fahey P4, Shim L2, Malcolm A2, Boyce P5.
BACKGROUND & AIMS:
Irritable bowel syndrome (IBS) is the most common chronic functional bowel disorder, with few treatment options. IBS affects 10%-20% of the population; as many as 58% of patients have constipation-predominant IBS (IBS-C). We evaluated efficacy and safety of a standardized, specifically formulated Chinese herbal medicine (CHM) preparation in treatment of patients with IBS-C.
We performed a double-blind trial of 125 patients with IBS-C (according to Rome III criteria), who were recruited from 13 medical centers or clinics in Australia from July 2009 through February 2012. Patients were randomly assigned to groups given a standardized extract of 7 selected CHM ingredients (n = 61) or placebo (controls, n = 64) for 8 weeks (5 capsules, twice daily). Subjects were then followed for 16 weeks. Chemical definition, standardization, and stability testing of the formulation were completed. Subjects completed a self-administered, validated binary questionnaire of global symptom improvement at weeks 2, 4, 8, and 16 (primary outcome). Secondary outcomes included results from the self-administered IBS Symptom Severity Scale and the Bristol Stool Form Scale (BSFS), which were completed at weeks 4, 8, and 16.
There was statistically and clinically significant (per protocol analyses) improvement among subjects who received CHM (n = 50) vs controls (n = 58) for 8 weeks. A greater proportion of subjects receiving CHM reported adequate relief (P = .010). Compared with controls, the CHM group had improved bowel habits vs controls at week 8, including lower IBS Symptom Severity Scale scores (P < .001), reduced straining during defecation (P = .002), and a significant decrease in hard lumpy stools (P = .031). The CHM group also had increased stool consistency, which was based on the Bristol Stool Form Scale (week 8, P < .001). There was no statistically significant difference between groups in abdominal pain at week 8 (P = .692). The CHM was well-tolerated.
In a prospective, controlled study, CHM reduced symptoms of IBS-C, increased bowel satisfaction and stool consistency, and reduced straining and hard lumpy stools, compared with placebo.
Electro-acupuncture better than drugs for constipation
Chinese authors have concluded that electro-acupuncture is more effective than medication for improving the symptoms of functional constipation (FC). Analysing the results of nine randomised studies, they found a small but significant increase in the frequency of spontaneous bowel movements in patients treated with EA, compared with those receiving anti-constipation medicine. Greater improvement was also observed in treatment response rates and constipation scores in EA-treated patients compared with medication-treated patients.
Comparison of electroacupuncture and medical treatment for functional constipation: a systematic review and meta-analysis. Acupunct Med. 2017 Jun 19. pii: acupmed-2016-011127.